Healthcare provider experiences interacting with survivors of intimate partner violence: a qualitative study to inform survivor-centered approaches

Ronald Anguzu; Laura D Cassidy; Annettee O Nakimuli; Judith Kansiime; Harriet M Babikako; Kirsten M M Beyer; Rebekah J Walker; Christopher Wandira; Felix Kizito; Julia Dickson-Gomez

doi:10.1186/s12905-023-02700-w

Healthcare provider experiences interacting with survivors of intimate partner violence: a qualitative study to inform survivor-centered approaches

BMC Womens Health. 2023 Nov 8;23(1):584. doi: 10.1186/s12905-023-02700-w.

Authors

Affiliations

¹ Division of Epidemiology and Social Sciences, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, US. ranguzu@mcw.edu.
² Division of Epidemiology and Social Sciences, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, US.
³ Department of Obstetrics and Gynaecology, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.
⁴ Action for Community Development (ACODEV), Kampala, Uganda.
⁵ Department of Epidemiology and Biostatistics, Makerere University School of Public Health, Makerere University College of Health Sciences, New Mulago Gate Road, Mulago, Kampala, Uganda.
⁶ Department of Child Health and Development Center, School of Medicine, College of Health Sciences, Makerere University, Hospital Complex, P.O. Box 7072, Mulago Hill, Kampala, Kampala, Uganda.
⁷ Center for Advancing Population Sciences (CAPS), Medical College of Wisconsin, Milwaukee, WI, US.
⁸ Division of General Internal Medicine, Medical College of Wisconsin, Milwaukee, WI, US.
⁹ District Health Office, Luuka District Local Government, Iganga, Uganda.

Abstract

Background: Intimate partner violence (IPV) remains a pervasive form of gender-based violence (GBV) that is largely undisclosed, especially among women seeking healthcare services in Uganda. Prioritizing survivor needs may improve IPV disclosure. This study explores healthcare worker experiences from provider-patient interactions with survivors seeking antenatal care services (ANC) in Uganda.

Methods: In-depth interviews were conducted among twenty-eight experienced healthcare providers in a rural and an urban-based ANC clinic in Eastern and Central Uganda. Providers were asked what they viewed as the needs and fears of women identified as having experienced any form of IPV. Iterative, inductive/deductive thematic analysis was conducted to discover themes regarding perceived needs, fears, and normalizing violence experienced by IPV survivors.

Results: According to healthcare providers, IPV survivors are unaware of available support services, and have need for support services. Providers reported that some survivors were afraid of the consequences of IPV disclosure namely, community stigma, worries about personal and their children's safety, retaliatory abuse, fear of losing their marriage, and partners' financial support. Women survivors also blamed themselves for IPV. Contextual factors underlying survivor concerns included the socio-economic environment that 'normalizes' violence, namely, some cultural norms condoning violence, and survivors' unawareness of their human rights due to self-blame and shame for abuse.

Conclusions: We underscore a need to empower IPV survivors by prioritizing their needs. Results highlight opportunities to create a responsive healthcare environment that fosters IPV disclosure while addressing survivors' immediate medical and psychosocial needs, and safety concerns. Our findings will inform GBV prevention and response strategies that integrate survivor-centered approaches in Uganda.

Keywords: Intimate partner Violence; Qualitative study; Survivor-centered approach; Uganda.

MeSH terms

Ambulatory Care Facilities
Child
Female
Health Personnel
Humans
Intimate Partner Violence* / psychology
Pregnancy
Prenatal Care
Qualitative Research
Survivors* / psychology
Violence